Meaningful Measures – Meaningful Change or Meaningless Hype?

They say the only constant is change and for the most part change is a good thing. However, I have a bit of a love/hate relationship with change. I embrace the fact that it forces and challenges me to adapt which allows personal and professional growth, but I hate the disruption it causes to my “known,” especially when that “known” took me forever to figure out…such as healthcare quality measures!

The Centers for Medicare and Medicaid Services (CMS) introduced a new initiative a few months ago, to help providers streamline and reduce the reporting of quality measures and shift the focus on those key metrics closely tied to quality of care and improved patient outcomes – this initiative is known as Meaningful Measures.

Why the Change

Meaningful Measures is in response to the fact that the healthcare industry was being required to report on countless measures, most of which were redundant and provided minimal value to providers or their patients. CMS’s Administrator, Seema Verma acknowledge this by stating, “We need to move from fee-for-service to a system that pays for value and quality – but how we define value and quality today is a problem. We all know it: Clinicians and hospitals have to report an array of measures to different payers. There are many steps involved in submitting them, taking time away from patients. Moreover, it’s not clear whether all of these measures are actually improving patient care.” She reiterated, “It’s better to focus on achieving results, as opposed to having CMS try to micromanage and measure processes.1”

What’s “Meaningful?”

With the main objective being to achieve high quality care and meaningful outcomes for patients, the focus will be on those measures that2:

Address high impact measure that safeguard public health

Are patient centered

Are outcomes bases where possible

Relevant for and meaningful to providers

Minimize level of burden for providers

Provide significant opportunity for improvement

Address measure needs for population based payment through alternative payment models

Align across programs and/or with other payers (Medicaid, commercial payers”

More so, CMS’s has aligned their core program goals to specific measure areas2:

What’s the Reaction?

The emphasis on quality care and patient centered outcomes versus process measures, aligns with the healthcare industry’s primary objective, so, for the most part, response to the initiative seems to be fairly positive from both payers and providers. However there is still some skepticism on the perceived impact of this change and concern on what are considered “meaningful” measures and if CMS’s effort will truly reduce any burden at all, given that the core objectives, “include virtually everything, so they haven’t narrowed anything down,” according to Robert Berenson, a health policy fellow at the Urban Institute3.

In addition, the subjectivity in the industry on which quality measures are considered “meaningful” can lead to lack of consensus and in turn potentially increase the number of measures. According to Dr. Kedar Mate, chief innovation and education officer at the Institute for Healthcare Improvement, “What we want to do is measure the things that matter the most, and the only judge and jury of that are the patients we serve” and both providers and payers agree, that patient-reported outcome measures is seen as the true outcome measurement tool3.

Change can present us with great opportunities that can lead to even greater opportunities. Therefore, even though Meaningful Measures could possible disrupt my known knowledge on quality measures some, I will accept this change, no matter how small some may think it is, because I know that even the smallest change can have a big impact…and fingers crossed that impact is truly improved care and outcomes for all.

What do you think? Do you think this shift in quality measure reporting will improve the patient-provider relationship? Do you think that patient-reported outcome measures are the only measures really needed?